<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">
        
        <div class="layui-form-item">
            <label class="layui-form-label">用户ID</label>
            <div class="layui-input-block">
                <input type="text" name="user_id" class="layui-input" lay-verify="required" placeholder="请输入用户ID" value="0">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">手机号</label>
            <div class="layui-input-block">
                <input type="text" name="mobile" class="layui-input" lay-verify="required" placeholder="请输入手机号" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">注销类型</label>
            <div class="layui-input-block">
                <input type="text" name="unset_type" class="layui-input" lay-verify="required" placeholder="请输入注销类型" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">注销原因</label>
            <div class="layui-input-block">
                <input type="text" name="reason" class="layui-input" lay-verify="required" placeholder="请输入注销原因" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">注销前昵称</label>
            <div class="layui-input-block">
                <input type="text" name="old_user_nickname" class="layui-input" lay-verify="required" placeholder="请输入注销前昵称" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">注销前头像</label>
            <div class="layui-input-block">
                <input type="text" name="old_avatar" class="layui-input" lay-verify="required" placeholder="请输入注销前头像" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">审核状态</label>
            <div class="layui-input-block">
                <select name="status" lay-verify="required">
                    <option value=''></option>
                    {foreach $select_list_status as $k=>$v}
                    <option value='{$k}' >{$v}</option>
                    {/foreach}
                </select>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">注销时间</label>
            <div class="layui-input-block">
                <input type="text" name="unset_time" class="layui-input" lay-verify="required" placeholder="请输入注销时间" value="0">
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>

    </form>
</div>